Decode Medicine from OPD to ICU rounds
Community Acquired Pneumonia Community-acquired pneumonia (CAP) is an acute infection of the lung parenchyma occurring in a non-hospitalized individual or developing ≤48 hours of hospital admission, not residing in long-term care and without recent healthcare exposure. Category Definition Clinical relevance CAP Outside hospital or ≤48 hr admission Standard community pathogens HAP ≥48 hr after admission […]
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Septic Cardiomyopathy (Sepsis-Induced Myocardial Dysfunction, SIMD) Septic cardiomyopathy (SCM) is an acute, reversible myocardial dysfunction occurring during sepsis or septic shock(20–60% of septic shock patients), characterized by: Reduced myocardial contractility Ventricular dilatation Impaired response to fluid and catecholamines Usually recovers within 7–10 days in survivors SCM occurs without acute coronary artery occlusion and is caused
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Warfarin Induced Coagulopathy (Warfarin Over-Anticoagulation) Normal Vitamin K Cycle Vitamin K is required for γ-carboxylation of: Factors II, VII, IX, X Protein C Protein S Vitamin K is recycled by:Vitamin K epoxide reductase (VKORC1) Warfarin inhibits VKORC1.Factor VII falls first—>PT/INR rises within 24–36 hours.Maximum anticoagulant effect:≈ 5 days Causes of Warfarin-Induced Coagulopathy 1. Excess Dose
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Intracerebral Hemorrhage (ICH) 1️⃣ Introduction It accounts for: 10–15% of all strokes But causes disproportionately high mortality (35–50%) 2️⃣ Classification A. By Etiology Type Cause Primary ICH Hypertension, cerebral amyloid angiopathy Secondary ICH AVM, aneurysm, tumor, anticoagulation, trauma B. By Location Deep ICH (Hypertensive)- Pathophysiology- presence of small penetrating arteries in deeper lobe with no
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Acute Diarrhoea 1. Definition Acute diarrhoea = Passage of ≥3 loose/watery stools per day lasting <14 days. Persistent: 14–28 days Chronic: >4 weeks Always clarify duration, volume, blood, travel, antibiotics, immunocompromise, and systemic toxicity. Acute Diarrhoea vs Dysentery Feature Acute Watery Dysentery Stool Watery Blood + mucus Fever Mild High Pain Mild Severe cramps Cause
Asymptomatic Bacteriuria (ASB) Asymptomatic bacteriuria (ASB) is defined as: Presence of significant bacterial growth in urine in a patient WITHOUT signs or symptoms attributable to urinary tract infection (UTI). Symptoms that must be absent include: Dysuria Frequency Urgency Suprapubic pain Flank pain Fever attributable to UTI Costovertebral angle tenderness Diagnostic Criteria Standard Definition (IDSA 2019)
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Catheter Associated Urinary Tract Infection (CAUTI) Definition A Catheter-Associated Urinary Tract Infection (CAUTI) is a UTI occurring in a patient with: An indwelling urinary catheter in place for >2 calendar days OR Catheter removed within the previous 48 hours with: Compatible symptoms/signs of UTI AND Significant bacteriuria. Catheter-Associated Asymptomatic Bacteriuria (CA-ASB) Bacteria in urine without
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Upper UTI/Pyelonephritis Pyelonephritis is a bacterial infection of the renal pelvis and renal parenchyma causing inflammation of the kidney. It represents the upper spectrum of urinary tract infection (UTI). Acute Pyelonephritis Acute suppurative bacterial infection involving: Renal pelvis/Collecting system/Renal interstitium/Renal tubules Usually occurs due to: Ascending infection from lower urinary tract Less commonly hematogenous spread
Portopulmonary Hypertension (PoPH) Definition Portopulmonary Hypertension (PoPH) is a form of pulmonary arterial hypertension (PAH, Group 1 PH) that develops in patients with: Portal hypertension (with or without cirrhosis) Increased pulmonary vascular resistance due to pulmonary arteriopathy Normal left-sided filling pressures Diagnosis requires: 1. Portal Hypertension Evidence of: Cirrhosis Non-cirrhotic portal hypertension Portosystemic shunts AND
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Acute Cholangitis 1. Definition Acute cholangitis is a life-threatening ascending infection of the biliary tree occurring due to biliary obstruction + bacterial infection. Classic triad = Charcot’s triad Fever Jaundice Right upper quadrant pain Severe disease = Reynolds pentad Charcot triad Hypotension Altered mental status Charcot triad present in ~50–70% only → absence does NOT